经平坦部玻璃体切除术和晶状体切除术治疗的外伤性晶状体脱位和半脱位的视觉预后

Visual Outcomes of Traumatic Lens Dislocations and Subluxations Managed by Pars Plana Vitrectomy and Lensectomy.

作者信息

Hapca Mădălina-Claudia, Muntean George-Adrian, Nemeș-Drăgan Iulia-Andrada, Vesa Ștefan Cristian, Nicoară Simona-Delia

机构信息

Doctoral School of Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, V. Babeș Str. 8, 400012 Cluj-Napoca, Romania.

Ophthalmology Clinic, Emergency County Hospital, 3-5 Clinicilor Str., 400006 Cluj-Napoca, Romania.

出版信息

J Clin Med. 2023 Nov 8;12(22):6981. doi: 10.3390/jcm12226981.

DOI:10.3390/jcm12226981

PMID:38002596

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10671993/

Abstract

AIM

The aim of this study was to evaluate the visual outcome of lens dislocation and subluxation managed by pars plana vitrectomy (PPV) and lensectomy in patients with open (OGIs) or closed globe injuries (CGIs).

METHODS

Medical records of 70 consecutive patients treated by PPV and lensectomy over a period of 11 years (1 January 2010-31 December 2020) were retrospectively reviewed. We collected demographic data, best corrected visual acuity (BCVA) using a Snellen Chart pre- and postoperatively, associated ocular injuries and treatment strategy. Visual outcome was evaluated according to the final BCVA which was defined as poor <0.1 or good ≥0.1.

RESULTS

The mean age was 57.9 ± 17.6 years. CGIs were present in 49 (70.0%) cases and open OGIs in 21 (30.0%) cases. The dislocation mechanism was zonular lysis in 59 cases (84.3%) and capsular rupture in 11 cases (15.7%). The intraocular lens implant (IOL) was sutured to the sclera in 51 (72.9%) cases or positioned in the capsular bag or in the sulcus in 3 (4.3%) cases and 1 (1.4%) case, respectively, whereas 15 (21.4%) patients remained aphakic. A good BCVA ≥ 0.1 was achieved in 45.71% of the eyes. The presence of retinal detachment (RD) ( = 0.014), iridodonesis ( = 0.011) and initial BCVA ( = 0.000) achieved statistical significance in predicting visual outcome. After treatment, 45.71% of patients achieved a final BCVA ≥ 0.1.

CONCLUSION

RD, iridodonesis and initial BCVA were risk factors for poor visual outcome in our series.

摘要

目的

本研究旨在评估经扁平部玻璃体切除术（PPV）联合晶状体切除术治疗开放性眼球损伤（OGIs）或闭合性眼球损伤（CGIs）患者晶状体脱位和半脱位的视觉预后。

方法

回顾性分析11年期间（2010年1月1日至2020年12月31日）连续70例行PPV联合晶状体切除术患者的病历。收集人口统计学数据、术前和术后使用Snellen视力表测量的最佳矫正视力（BCVA）、相关眼外伤及治疗策略。根据最终BCVA评估视觉预后，最终BCVA<0.1为差，≥0.1为好。

结果

平均年龄为57.9±17.6岁。49例（70.0%）为CGIs，21例（30.0%）为开放性OGIs。脱位机制为悬韧带溶解59例（84.3%），晶状体囊膜破裂11例（15.7%）。51例（72.9%）患者将人工晶状体（IOL）缝合至巩膜，3例（4.3%）和1例（1.4%）患者分别将IOL置于晶状体囊袋或睫状沟内，15例（21.4%）患者仍为无晶状体眼。45.71%的患眼最终BCVA≥0.1。视网膜脱离（RD）（P=0.014）、虹膜震颤（P=0.011）和初始BCVA（P=0.000）在预测视觉预后方面具有统计学意义。治疗后，45.71%的患者最终BCVA≥0.1。